Youth who report sexual attraction to same-sex peers, sexual behavior with same-sex partners or identify as gay, lesbian and bisexual (GLB) report higher rates of substance use as compared to their heterosexual counterparts. In fact a recent meta-analysis found that the odds of substance use for GLB youth are 190% higher than for heterosexual youth with subpopulations substantially higher (340% higher for bisexual youth and 400% higher for female GLB youth). However, the literature remains unclear as to the dynamics of the relationship of sexual orientation and substance use. Research is needed exploring the role of substance use in the disclosure process of GLB youth. It is important to gain insight into these relationships to best inform future research on prevention and intervention for substance using GLB youth and their families. This research will provide a better understanding of what substance using GLB youth consider when deciding to disclose or not disclose to family. The central hypothesis of this proposal is based on the Consequences Theory of Disclosure originating from principles of social exchange theory. According to the theory, GLB youth weigh the rewards and costs of disclosing their status to family. When rewards outweigh costs disclosure occurs. There is little understanding of the specific factors (i.e., the rewards and costs) that youth might take into consideration when making disclosure to family decisions and how substance use might impact the assessment of these factors. Until these factors are uncovered, it will not be possible to clearly identify key components of the disclosure process. Specific Aim 1: Conduct formative research to explore the role of substance use in the disclosure process of GLB youth. Specific Aim 2: Explore the considerations given for disclosure and non-disclosure and subsequent reactions that will help inform the future development and implementation of a disclosure- related intervention for substance using youth and their families. This project is innovative for at least three reasons. First, few studies have explored how substance use has affected the lives of GLB adolescents through a qualitative investigation that centers the voices of GLB youth and parents. This honors the importance of their experiences. Second, this study focuses exclusively on the process of deliberation that occurs in sexual orientation disclosure or non-disclosure decisions to family and the subsequent reactions that affect future disclosure decisions. What happens during this process may serve to either protect youth from increased substance use or result in increased risk. There are no known studies that have comprehensively investigated such processes and how they may be even more complex for substance using youth. Finally, the nature of this research may shed light on other little understood aspects of the disclosure decision-making process, including the impact of substance use. This insight, in turn, may lead to novel hypotheses that will guide future research endeavors including prevention and intervention for substance using GLB youth and their families. PUBLIC HEALTH RELEVANCE: Disclosure of one's sexual orientation to family members creates considerable strain for gay, lesbian and bisexual (GLB) youth. This is complicated by the 190% odds of increased risk for GLB youth to use substances, as compared to non-GLB youth. Researchers have demonstrated that disclosing to family, particularly nuclear family members, may serve as a protective factor against reduced social support, mental health risks, and substance use. However the relationship between substance use and disclosure is unclear. The purpose of this project is to conduct formative research regarding the role of substance use in the disclosure process, the considerations given for disclosure and non-disclosure, and the subsequent reactions experienced in the family context. Research on disclosure to family for substance using GLB youth is essential because of the numerous stressors these youth experience related to this important piece of sexual identity development and integration.